Prime Minister Naftali Bennett declared on Tuesday that Israel was “very close” to making a decision on COVID vaccine booster shots, and on obtaining the additional doses needed to make that happen, but health experts around him remain divided on the issue.
Bennett's remarks come two weeks after the World Health Organization and the U.S. Centers for Disease Control said there was no need at this time for a third dose, but as Israel's Health Ministry data showed a sharp decline in the efficacy of the vaccine against contagion and a slight decline in preventing severe illness.
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As the coronavirus infection rate reached a four-month peak on Tuesday, Israel’s epidemiology treatment team and the vaccination committee, who are advising the prime minister, are still split on the need for the elderly to get boosters. They are scheduled to meet Wednesday for further discussion after failing to reach a consensus at a meeting last week.
A slim majority on the vaccination committee supports a third dose for the elderly, but it has not yet made a recommendation to the Heath Ministry director general, Prof. Nachman Ash, who has the final say.
In a meeting with directors of Israel's hospitals, Ash said that a decision will be made "in the coming days" and that the elderly will be the "first priority." Sources said that the director general prefers to wait until there is a firm majority among experts about a booster before making a decision.
Slim majority in favor, but no verdict
At the conclusion of the vaccination committee’s last meeting on July 18, 22 of the 42 members held that older people should get a third dose “while explaining to this population about the limits of our current knowledge and that there is no place at this stage to vaccinate young and healthy population,” according to the wording of the resolution.
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Three committee members voted for giving a third dose to the entire population “because of the possibility of dwindling immunity.” Only 15 of the 25 experts who voted for the third dose took the view that it should be recommended before the U.S. Food and Drug Administration had approved it.
At the end of the meeting, it was decided that “in light of the wide range of opinions regarding a third dose, on firm recommendation is being made on this issue.” The minutes noted: “It must be stressed there is no consensus concerning directives of administering a third dose now when regulatory authorities have not yet approved it.”
But data shown to the committee were quite limited. They were from studies conducted on their respective vaccines by Moderna, which included 20 participants with an average age of 63; Pfizer, which didn’t say how big its study was; and a third by AstraZeneca that comprised 80 subjects. In addition, another series of studies were presented that included about 200 immunosuppressed individuals.
The experts didn’t raise any issues about the safety of administering a third dose, just about its efficacy. They discussed whether the vaccine’s declining efficacy was due to the special characteristics of the delta variant or due to a deterioration in the efficacy of the vaccine generally over time. Some suggested it might be a combination of the two.
Research in Israel is due to begin to investigate the efficacy and safety of a third dose. Prof. Galia Rahav, the head of the Infectious Disease Unit and Laboratories at Sheba Medical Center, Tel Hashomer who will be leading the study, said her team had already gotten government approval for testing on human subjects and was now awaiting approval from Pfizer. She said she hoped to begin next week.
“We’re seeing a distinct drop in antibody levels. We’re seeing that those who are really sick now are mostly the elderly and that those who were vaccinated in January are at a higher risk of getting sick than those who are vaccinated in April,” she said.
However, she stressed that “every vaccine shows a decrease in immunity, and we know that adults respond less to vaccines than young people. This is nothing new, but we do not have that much data.”
Prof. Ran Balicer, who heads a panel of experts advising the Health Ministry, told Haaretz that “the current restrictions have proven over recent weeks that they do not stop the spread of the disease in Israel.”
“The government has to decide strategically whether a continued rise like this is a policy. And if so, it has to be taken into account that if they regret it later, the variety of tools available to stop the spread will be more limited – and will include only means that do extreme damage to the economy and society,” he added.
Prof. Balicer also noted that ‘serious’ coronavirus patients are generally less ill now than in previous COVID outbreaks in Israel.